The Prevalence And Analysis Of Risk Factors For Postpartum Anemia In Women Without Prepartum Anemia

Abstract

Introduction: Postpartum anemia is a significant and common public health issue. Here, the prevalence of postpartum anemia and predisposing factors in women without prepartum anemia was investigated. Methods: This retrospective study was conducted between February 2018 and April 2018 with 1013 patients without prepar-tum anemia. Sociodemographic features, delivery characteristics, and hemoglobin levels of the patients were recorded. Variables were compared between the anemic and nonanemic groups, independent predictors were determined, and risk score for postpartum anemia was calculated. Results: The rate of cesarean section and emergent cesarean, the frequency of episiotomy and perineal laceration, and the application of general anesthesia were higher, whereas mean gestational week at birth and the ratio of active management of the third stage of labor were lower in the anemic group. In regression analysis, episiotomy (odds ratio (OR) 5.45, 95% confidence interval (CI) 3.75-7.93, p<0.001), perineal laceration (OR 7.09, 95% CI 2.88-17.47, p<0.001), active management (OR 0.09, 95% CI 0.06-0.12, p<0.001), general anesthesia (OR 3.9, 95% CI 0.99-15.32, p=0.026), and emergent cesarean (OR 19.35, 95% CI 10.57-35.41, p<0.001) were found to be significant independent predictors. The formula of risk score calculated to determine patients who were under risk to develop postpartum anemia was as follows: risk score=(5×episiotomy)+(7×per-ineal laceration)+(3×general anesthesia)+(19×emergent cesarean)−(11×active management). Risk score >−4 was found to be a predictor for postpartum anemia with a sensitivity of 73.7% and specificity of 81.1%, and it increases the risk of postpar-tum anemia approximately 12 times. Discussion and Conclusion: The prevalence of postpartum anemia is quite high in our clinic, and so a non-selective screening program for postpartum anemia could be applicable. However, determining patients under high risk is still important to be alert to prevent short-and long-term morbidities.